Quality Measures Research Articles

Indoor/Outdoor Air Quality Measurements near a Highway in Somerville, MA

Indoor/Outdoor Air Quality Measurements near a Highway in Somerville, MA

The Development of the Secure Quality Dataset (SQDS): Combining Security and Quality Measures Using Deep Machine Learning for Code Smell Detection

The Development of the Secure Quality Dataset (SQDS): Combining Security and Quality Measures Using Deep Machine Learning for Code Smell Detection

Introducing PLEMS: the application of a low-cost, portable monitoring system in environmental walks.

The application of innovative systems using low-cost microcontrollers in human biometeorology studies is a promising alternative to conventional monitoring devices, which are usually cost-intensive and provide measurements at specific points, as in stationary meteorological stations. A Portable Low-cost Environmental Monitoring System (PLEMS) aimed at the pedestrian scale is introduced. The backpack-type equipment consists of a microcontroller with attached sensors that assess environmental conditions in a broad sense, integrating measurements of air quality, lighting and noise levels alongside variables typically measured at meteorological stations. The application of the system took place in altogether 12 environmental walks carried out with questionnaire-surveys with concurrent environmental monitoring with the PLEMS in Curitiba, Brazil, a subtropical location characterized by a Cfb climate type. Results allowed us to test the equipment and method of data gathering within a limited period (approximately 50 min) and for a short walking circuit of 800 m. The equipment was successfully able to capture even slightest differences in environmental conditions among points of interest, whereas subjective responses (n= 3843 responses to a total of 11 questions) showed consistency with measured data. From a multi-domain perspective, relevant insights could be obtained for the measured variables.

Analyzing quality of life among people with opioid use disorder from the National Institute on Drug Abuse Data Share initiative: implications for decision making.

We aimed to estimate health state utility values (HSUVs) for the key health states found in opioid use disorder (OUD) cost-effectiveness models in the published literature. Data obtained from six trials representing 1,777 individuals with OUD. We implemented mapping algorithms to harmonize data from different measures of quality of life (the SF-12 Versions 1 and 2 and the EQ-5D-3L). We performed a regression analysis to quantify the relationship between HSUVs and the following variables: days of extra-medical opioid use in the past 30 days, injecting behaviors, treatment with medications for OUD, HIV status, and age. A secondary analysis explored the impact of opioid withdrawal symptoms. There were statistically significant reductions in HSUVs associated with extra-medical opioid use (-0.002 (95% CI [-0.003,-0.0001]) to -0.003 (95% CI [-0.005,-0.002]) per additional day of heroin or other opiate use, respectively), drug injecting compared to not injecting (-0.043 (95% CI [-0.079,-0.006])), HIV-positive diagnosis compared to no diagnosis (-0.074 (95% CI [-0.143,-0.005])), and age (-0.001 per year (95% CI [-0.003,-0.0002])). Parameters associated with medications for OUD treatment were not statistically significant after controlling for extra-medical opioid use (0.0131 (95% CI [-0.0479,0.0769])), in line with prior studies. The secondary analysis revealed that withdrawal symptoms are a fundamental driver of HSUVs, with predictions of 0.817 (95% CI [0.768, 0.858]), 0.705 (95% CI [0.607, 0.786]), and 0.367 (95% CI [0.180, 0.575]) for moderate, severe, and worst level of symptoms, respectively. We observed HSUVs for OUD that were higher than those from previous studies that had been conducted without input from people living with the condition.

Optimizing preoperative bone health assessment for adult spinal deformity: a prospective correlation analysis of intraoperative pedicle screw insertion torque and imaging modalities in Japan.

Prospective cohort study. This study aimed to identify the optimal preoperative bone health assessment for adult spinal deformity (ASD) surgery through correlation analysis between intraoperative pedicle screw (PS) insertion torque and various bone quality measures, including bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry (DEXA), Hounsfield unit (HU) by computed tomography (CT), and vertebral bone quality (VBQ) score by magnetic resonance imaging. Existing data on optimal assessment tools for ASD surgery are limited. The study included patients with ASD aged >60 years who underwent spinal corrective fusion surgery from the lower thoracic spine to the pelvis. The intraoperative PS insertion torque was measured using a torque meter. Pearson correlation coefficients were calculated between the PS insertion torque and the BMD, HU, and VBQ score. Preoperative bone quality was compared between the proximal junctional failure (PJF) and non-PJF groups. Thirty-one patients with 177 PS at T10, T11, and T12 were analyzed. The PS insertion torque showed a moderate positive correlation with lumbar spine BMD (r=0.59-0.69, p<0.01), total hip BMD (0.58-0.62, p<0.01), and HU value (r=0.58-0.66, p<0.01). However, the VBQ score did not show significant correlation (r=-0.28 to -0.23, p >0.05). Notably, a strong correlation was found between the PS insertion torque and the HU value for screws of the same size (r=0.71 and 0.74, p<0.01). The HU value at T12 and the PS insertion torque at T10 were significantly lower in the PJF group than in the non-PJF group. This study demonstrates a positive correlation between the PS insertion torque and HU value in the lower thoracic spine and a moderate correlation with BMD but not the VBQ score. Preoperative assessment using DEXA and CT is crucial for optimizing bone health management in ASD surgery.

Developing mapping algorithms to predict EQ-5D health utility values from Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index among patients with Ankylosing Spondylitis

BackgroundPreference-based measures of health-related quality of life (HRQoL), such as the EQ-5D or the SF-6D, are essential for health economic evaluation. However, they are rarely included in clinical trials of ankylosing spondylitis (AS). This study aims to develop mapping algorithms to predict EQ-5D-3L and EQ-5D-5L health utility scores from the Bath Ankylosing Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI).MethodsPatients with AS were recruited from the largest tertiary hospital in Shandong province, China, between December 2019 and October 2020. Patients were selected by convenience sampling method according to the following criteria: (1) diagnosed with AS according to the New York criteria; (2) aged 18 years and above; and (3) without mental disorders; (4) able to understand the questionnaires; (5) without serious complications. There were 243 patients who completed the face-to-face questionnaire survey, and 5 cases with missing values in key variables were excluded. Ordinary least squares, censored least absolute deviations, Tobit, adjusted limited dependent variable mixture model and beta-mixture model (BM) in the direct approach and ordered logit and multinomial logit (Mlogit) model in the response approach were used to develop mapping algorithms. Mean absolute error, root mean square error, Spearman’s correlation coefficient and concordance correlation coefficient were used to access predictive performance.ResultsThe 238 patients with AS had a mean age of 35.19 (SD = 9.59) years, and the majority (74.47%) were male. The observed EQ-5D-3L and EQ-5D-5L health utility values were 0.88 (SD = 0.12) and 0.74 (SD = 0.27), respectively. The EQ-5D-5L had higher conceptual overlap with the BASDAI and BASFI than the EQ-5D-3L did. The Mlogit was the best-performing model for the EQ-5D-3L, and the BM showed better performance in predicting EQ-5D-5L than other direct and indirect mapping models did.ConclusionThis study demonstrates that the EQ-5D-5L, rather than EQ-5D-3L, should be selected as the target outcome measure of HRQoL in patients with AS in China, and the BM mapping algorithm could be used to predict EQ-5D-5L values from BASDAI and BASFI for health economic evaluation.

An Examination of Stream Water Quality Data from Monitoring of Forest Harvesting in the Eastern Highlands of Victoria

A large data set measuring surface stream turbidity, dissolved oxygen levels, and water temperature was developed by sampling 32 rivers and streams with forested catchments at weekly intervals for between two and three years. This was in response to allegations of possible water quality impairment by forest harvesting (“logging”). Additionally, nine rivers or streams external to the forests were sampled to form a “reference set”; concern was expressed that the water quality of these may be impaired by upstream forest harvesting. An unlogged forested control catchment was selected from the data set and used as a comparator to help reduce seasonal variation. Division of the data into “logged forested catchments” and “unlogged forested catchments” allowed for us to test the null hypothesis. The null hypothesis was that there was no difference between the means of the logged and unlogged sets by a “Student’s t test of difference between means”. The null hypothesis was supported for the three parameters. There was no discernible deterioration in water quality associated with the presence of logging in the stream catchments. It was concluded that logging in this environment was not a determinant of water quality, and that the presence or absence of logging in these catchments did not affect the measured water quality. Spearman rank correlation analysis was unable to detect any statistically significant correlations between the water quality parameters, suggesting they are substantially independent measures of water quality. The monitoring showed that the small upland streams had generally good-to-excellent water quality. The water quality in these was generally better than the “reference set”—this probably reflected agriculture and cultivation in the proximity of their sampling points.

Preparation and Rationale for a Patient-Reported Clinical Outcome Assessment Set of Fluid Overload for Drug Development in Nephrotic Syndrome

Introduction: Fluid overload is a source of substantial morbidity for adults and children with nephrotic syndrome (NS). Preparation and Rationale for a Fluid Overload in Nephrotic Syndrome Clinical Outcomes Assessment Set for Drug Development (Prepare-NS, 5UG3FD007308) was funded by the U.S. Food and Drug Administration to develop a core set of patient-reported and observer-reported (for young children) outcome measures of fluid overload for use in pharmaceutical trials across the lifespan. Methods: The Prepare-NS study team developed the proposed context of use with input from stakeholders. We conducted a scoping review to assess the available literature on relevant patient- and observer-reported measures and performed secondary analyses of existing qualitative and quantitative data. Results: The outcome set will aim to serve individuals two years of age and older with primary nephrotic syndrome conditions (specifically focal segmental glomerulosclerosis, minimal change disease, IgM nephropathy, membranous nephropathy, and childhood–onset nephrotic syndrome not biopsied). The existing literature describing patient reported outcomes in nephrotic syndrome largely relies on non-specific measures of health-related quality of life; fluid overload has been associated with lower scores on these measures. Conclusion: To address the gap in measure availability and fluid overload content, the Prepare-NS team has launched a set of qualitative studies for concept elicitation from the population of interest to inform development of new measures. The resulting measures subsequently will undergo psychometric evaluation and validation in a survey study.

The associations between sibling influence and perception of sibling relationship quality among adolescents: The moderating role of birth order

This study examined the longitudinal associations between perception of sibling relationship quality (i.e., sibling warmth and conflict) and sibling influence (i.e., sibling modeling and differentiation), as well as the potential moderating role of birth order among Chinese adolescents. Participants were 150 adolescents ( Mage = 12.84 years, SD = 0.71; gender combination: 41.22% same-sex pairs) from Huzhou, Zhejiang Province, China. Measures of sibling relationship quality and sibling influence were collected via self-reports at two time points, 6 months apart. We study at the individual level and the target child is one of a pair of siblings. Results based on a cross-lagged model indicated that (a) perceiving sibling relationship as warmer positively predicted imitating one’s sibling, (b) imitating one’s sibling positively predicted perceiving sibling relationship as more conflicted for younger siblings but not for older siblings, and (c) perceiving sibling relationship as warmer positively predicted differentiating one’s sibling for older siblings but not for younger siblings. These findings illustrate reciprocal associations between perception of sibling relationship quality and sibling influence.

Comparative effectiveness of interventions for cancer treatment–related cognitive impairment in adult cancer survivors: protocol for a systematic review

BackgroundCancer treatment–related cognitive impairment (CTRCI) can substantially reduce the quality of life of cancer survivors. Many treatments of CTRCI have been evaluated in randomized controlled trials (RCTs), including psychological interventions, pharmacologic interventions, and other therapies. There is a pressing need to establish the benefits and harms of previously studied CTRCI treatments. The proposed systematic review and network meta-analyses will assess the relative efficacy and safety of competing interventions for the management of CTRCI.MethodsIn consultation with the review team, an experienced medical information specialist will draft electronic search strategies for MEDLINE®, Embase, CINAHL, PsycINFO, and the Cochrane Trials Registry. We will seek RCTs of interventions for the treatment of CTRCI in adults with any cancer, except cancers/metastases of the central nervous system. Due to the anticipated high search yields, dual independent screening of citations will be expedited by use of an artificial intelligence/machine learning tool. The co-primary outcomes of interest will be subjective and objective cognitive function. Secondary outcomes of interest will include measures of quality of life, mental and physical health symptoms, adherence to treatment, and harms (overall and treatment-related harms and harms associated with study withdrawal), where feasible, random-effects meta-analyses and network meta-analyses will be pursued. We will address the anticipated high clinical and methodological heterogeneity through meta-regressions, subgroup analyses, and/or sensitivity analyses.DiscussionThe proposed systematic review will deliver a robust comparative evaluation of the efficacy and safety of existing therapies for the management of CTRCI. These findings will inform clinical decisions, identify evidence gaps, and identify promising therapies for future evaluation in RCTs.

Comparing Quality, Costs, and Outcomes of VA and Community Primary Care for Patients with Diabetes.

The Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act expanded access to independent community providers outside the Veterans Health Administration (VA). Little is known how quality, costs, and outcomes of primary care received in the community compare to that of the VA. To compare quality, costs, and outcomes of community and VA-provided primary care for patients with diabetes over a 12-month episode. A cross-sectional study using VA administrative data and community care claims. Adjusted analyses were conducted using inverse probability weighted regression adjustment to balance patient characteristics. Veterans with diabetes receiving primary care in the VA or community. Quality measures included receipt of hemoglobin A1C tests, eye exams, microalbumin urine tests, and flu shots. Outcomes were measured by hospitalizations for an ambulatory care sensitive condition (ACSC). Costs were measured for VA and community outpatient care, inpatient care, and prescription drugs. There were 652,648 VA patients and 3650 community care patients. VA patients were less likely to be White, had shorter mean drive time to VA primary care, and were less likely to be rural than community care patients. In adjusted analyses, community care patients had significantly lower probability of receiving a hemoglobin A1C test, eye exam, microalbumin urine test, and flu shot compared to the VA group. There was no difference in probability of an ACSC hospitalization. Community care patients had higher mean total costs ($1741 [95% CI, $431, $3052]), driven by higher inpatient and prescription drug costs but lower emergency care costs than VA patients. Patients receiving community primary care had worse diabetes quality and higher costs than patients receiving VA primary care. There was no difference in health outcomes. Care provided by an integrated delivery system may have advantages in quality and value.

Healthcare Utilization and Chronic Disease Management for Non-Medicaid-Eligible Patients in a City-Wide Safety-Net Healthcare Access Program.

In 2019, New York City (NYC) launched NYC Care (NYCC), a healthcare access program through NYC Health + Hospitals (H + H) for individuals who are ineligible for federally funded health insurance programs or cannot purchase insurance through the State Marketplace, predominantly undocumented individuals. To examine the sociodemographic characteristics, healthcare use patterns, and chronic disease quality measures for diabetes mellitus (DM) and hypertension among NYCC patients compared with Medicaid patients seen at NYC H + H. Observational study. Adults aged 18years and older enrolled in NYCC (N = 83,003) or Medicaid (N = 512,012) as of January 1, 2022. Patients were included if they had at least one visit between January 1, 2021, and December 31, 2021. Sociodemographic characteristics, healthcare use patterns, and quality measures for DM and hypertension. NYCC patients (n = 83,003) were, on average, older, more likely to be Hispanic with Spanish as their preferred language, had more comorbidities, and had more primary care (adjusted incidence rate ratio 2.75 [95% confidence interval 2.71, 2.80]) and specialty care (2.22 [2.17, 2.26]) visits compared to Medicaid patients (n = 512,012). Rates of emergency department visits were similar between the two groups (1.02 [1.00, 1.04]), but NYCC patients had relatively fewer hospitalizations (0.64 [0.62, 0.67]). NYCC patients with DM or hypertension had higher rates of having a documented hemoglobin A1c or blood pressure in 2022, respectively, and clinically similar rates of chronic disease control (mean difference in hemoglobin A1c - 0.05 [- 0.09, - 0.01] in patients with DM and mean difference in blood pressure - 0.38 [- 0.67, - 0.10]/ - 0.64 [- 0.82, - 0.46]) compared with Medicaid patients. NYCC effectively enrolled a large number of uninsured participants and provided them with healthcare access similar to that of Medicaid patients. Future studies should evaluate the impact of NYCC enrollment on healthcare utilization and disease outcomes.

Kualitas Program Layanan Homecare Terhadap Tingkat Kepuasan Pasien : Literature Review

Background: Homecare is recovery, independence, fulfilling basic needs,choose the treatment nedded are called homecare, influences the success of health development. In overcoming health problems, health workers must be able to increase their professionalism in carrying out their duties to provide the best and highest quality services, so that patients and family members feel satisfied as measured by the factors. Purpose: This literature review research aims to find out how the quality of homecare service programs influences the level of patient satisfaction. Methods: There were 14 journals used in the literature review. Journal searches are carried out through Four databases : Google Scholar, Crossref, ProQuest, Emerald Insight.Results: Literature analysis shows that, there is a relationship between reliability, responsiveness, assurance, emphaty and tangible with the level of patient satisfaction.Conclusion: The quality of home services is influenced by several factors, the focus of quality measurement in Indonesia and several countries is similar. In other countries, quality seen in the nursing process, staff skills are called assurance. Quality is conceptualized as a continuous process, coordination of professional groups, prioritizing patient safety standards is called tangible, timeliness called responsiveness. In Indonesian quality is measured in five factors are tangible, responsiveness, reliability, assurance and empathy. These factors are most related to patient satisfaction in homecare services.

A Comparative Analysis of Healthcare Quality Perception Among Different Vulnerable Populations with and without Telehealth Utilization: A Cross-Sectional Study from the Health Information National Trends Survey.

The COVID-19 pandemic led to a rapid expansion of telehealth utilization in medicine. However, the quality measures associated with telehealth use remain unclear, particularly among vulnerable populations. This study aims to investigate the impact of telehealth on individuals' perception of overall quality care among vulnerable patient populations. This cross-sectional study utilized Health Information National Trends Survey data. The individuals' overall perception of healthcare quality was compared between populations that had at least one telehealth visit and non-telehealth users, who all had the option of utilizing telehealth. This comparison focused on vulnerable populations, considering differences in race and ethnicity (non-Hispanic white vs. non-Hispanic black/Hispanic individuals) and socioeconomic status (high vs. low). Multivariable logistic regressions were employed to ascertain the association between individuals' overall perceptions of quality care with and without telehealth utilization. A total of 2920 participants, representing an unweighted population of 114,608,302, were analyzed. The adjusted odds ratio (AOR) for at least one telehealth visit associated with individuals' overall perception of quality care among the entire survey population was 0.76 with a 95% CI of 0.51-1.13 (p = 0.173). The AOR was 0.83 (95% CI 0.39-1.77, p = 0.618) among the non-White population, and the AOR was 0.71 (95% CI 0.29-1.78, p = 0.462) among individuals with low SES. Although telehealth utilization has both its limitations and advantages compared to traditional clinical visits, no statistically significant differences in individuals' overall perception of quality care were identified among telehealth and non-telehealth users. These findings were also consistent across various vulnerable populations.

Fuzzy cognitive network process for software reliability and quality measurement: comparisons with fuzzy analytic hierarchy process

Fuzzy cognitive network process for software reliability and quality measurement: comparisons with fuzzy analytic hierarchy process

The validity of single-item measures of health-related quality of life across groups differing in acute respiratory symptom severity.

Practical considerations precluding health-related quality of life (HRQOL) monitoring in population and clinical research have spawned development of improved items for more brief surveys of frequently measured HRQOL outcomes. The aim of this study was to validate the use of the Quality of Life General (QGEN-8), a shorter 8-item alternative to the longer 36-item short form (SF)-36 Health Survey for measuring the same eight HRQOL domains across groups of adults with varying severity of acute respiratory symptoms, such as cough and sore throat. National Opinion Research Center (NORC) representative probability (N = 1,648) and supplemental opt-in (N = 5,915) U.S. adult samples were surveyed cross-sectionally online in 2020. Parallel analyses compared QGEN-8 and SF-36 estimates of group means for each of eight matching profile domains and summary physical and mental scores across groups differing in severity of acute symptoms and chronic respiratory conditions using analysis of covariance (ANCOVAs) controlling for socio-demographics and presence of chronic respiratory conditions. In support of discriminant validity, ANCOVA estimates of QGEN-8 means with SF-36 estimates revealed the same patterns of declining HRQOL with the presence and increasing severity of symptoms and chronic condition severity. QGEN-8® shows satisfactory validity and warrants further testing in cross-sectional and longitudinal population and clinical survey research as a more practical method for estimating group differences in SF-36 profile and summary component HRQOL scores.

Amplify Gait to Improve Locomotor Engagement in Spinal Cord Injury (AGILE SCI) trial: study protocol for an assessor blinded randomized controlled trial

BackgroundAmong ambulatory people with incomplete spinal cord injury (iSCI), balance deficits are a primary factor limiting participation in walking activities. There is broad recognition that effective interventions are needed to enhance walking balance following iSCI. Interventions that amplify self-generated movements (e.g., error augmentation) can accelerate motor learning by intensifying sensorimotor feedback and facilitating exploration of motor control strategies. These features may be beneficial for retraining walking balance after iSCI. We have developed a cable-driven robot that creates a movement amplification environment during treadmill walking. The robot applies a continuous, laterally-directed, force to the pelvis that is proportional in magnitude to real-time lateral velocity. Our purpose is to investigate the effects of locomotor training in this movement amplification environment on walking balance. We hypothesize that for ambulatory people with iSCI, locomotor training in a movement amplification environment will be more effective for improving walking balance and participation in walking activities than locomotor training in a natural environment (no applied external forces).MethodsWe are conducting a two-arm parallel-assignment intervention. We will enroll 36 ambulatory participants with chronic iSCI. Participants will be randomized into either a control or experimental group. Each group will receive 20 locomotor training sessions. Training will be performed in either a traditional treadmill environment (control) or in a movement amplification environment (experimental). We will assess changes using measures that span the International Classification of Functioning, Disability and Health (ICF) framework including 1) clinical outcome measures of gait, balance, and quality of life, 2) biomechanical assessments of walking balance, and 3) participation in walking activities quantified by number of steps taken per day.DiscussionTraining walking balance in people with iSCI by amplifying the individual’s own movement during walking is a radical departure from current practice and may result in new strategies for addressing balance impairments. Knowledge gained from this study will expand our understanding of how people with iSCI improve walking balance and how an intervention targeting walking balance affects participation in walking activities. Successful outcomes could motivate development of clinically feasible tools to replicate the movement amplification environment within clinical settings.Trial registrationNCT04340063.

Association of Overnight Fasting and Meal Irregularity with Nutrient Quality and Anthropometric Measures in Adults

Background: Timing, frequency, and regularity as chrono-nutrition are emerging fields in nutritional epidemiology. The authors investigated the association of irregularity in energy intake, frequency, and overnight fasting with nutrient quality and health. Methods: Iranian adults who attended the health center of Tehran participated in this cross-sectional study. Dietary intake was derived from 3-day 24-h dietary recalls of 850 participants. Weight, height, and blood pressure of the participants were measured, and frequency, irregularity, and overnight fasting were recorded from 24-h dietary recall. Then, intra-class correlation coefficient (ICC) was used to obtain the consistency of time regarding three main meals. Following that, energy density was measured and nutrient density was calculated using the nutrient rich food (NRF 9.3) index. Obesity was defined as body mass index (BMI) &gt;30 kg/m2, and blood pressure was measured. Results: The highest consistency regarding the time of meal was observed at breakfast. Frequency was positively related to the intake of fruit, energy, carbohydrate, and NRF 9.3 index (P&lt;0.05). Overnight fasting was negatively associated with fruit, vegetable, grain, energy intake, and NRF 9.3 index (P&lt;0.05). Moreover, irregularity in energy intake showed a negative and significant association with fruits, vegetables, and NRF9.3 (P&lt;0.05). Frequency was significantly associated with weight and diastolic blood pressure (DBP) after adjustment with covariates (P&lt;0.05) and overnight fasting was negatively related to body weight (P=0.009). Moreover, irregularity in energy intake showed a significant association with systolic blood pressure (SBP) (P=0.03). Conclusions: Frequency and regularity may have a potential positive association with dietary intake which is not associated with BMI. Nutrient density is higher among the participants with a higher number of eating occasions, more regular eaters, and shorter overnight fasting.

A novel approach for health state valuation: Multiple bounded dichotomous choice compared to the traditional standard gamble

Objectiveto assess the feasibility of a new stated preference approach, the multiple bounded dichotomous choice (MBDC), designed to generate value sets for preference-based measurement of health-related quality of life. MethodsMBDC and standard gamble (SG) tasks were completed to derive SF-6Dv2 value sets from a sample of the general population in Quebec, Canada. Participants were randomized between the two approaches: 6 health states were evaluated in SG and 11 health states in MBDC. Several models were used to estimate data in each approach, and the preferred models were chosen by using mean absolute error (MAE), logical consistency of parameters, and significance levels. Results of MBDC were compared with SG in terms of acceptability (self-reported difficulty and quality levels in answering, and completion time), consistency (monotonicity of model coefficients), accuracy (standard errors), dimensions coefficient magnitude, correlation between the value sets estimated, and the range of estimated values. The intra-class correlation coefficient (ICC) was computed to assess value sets' consistency. ResultsOut of 655 individuals who completed MBDC tasks and 828 who completed SG tasks, a total of 585 participants for MBDC and 714 for SG tasks were included for analysis. The preferred models for both approaches were GLS Tobit. No significant difference was observed in self-reported difficulties and qualities in answers among approaches, but MBDC had less excluded participants and was less prone to report difficulties in answering. Additionally, completion time in the MBDC group was significantly lower (99.80 vs 68.12 s). Most standard errors in the MBDC were lower than those in SG, and the number of non-significant parameters was also lower. The range of utility values generated by MBDC tended to be wider (−0.372 to 1) than those generated by the SG (−0.137 to 1) and the number of worse-than-dead states in MBDC (0.91%) was higher than for SG (0.08%). The Pain dimension was identified as the most significant, while the Vitality dimension showed the lowest significant decrement. Both approaches exhibited a tendency to overestimate severe health state values and underestimate better health state values. The correlation and ICC between the two value sets were 0.937 and 0.983, respectively. ConclusionBased on empirical evidence, it can be inferred that the MBDC method is not only feasible but also holds the potential to generate meaningful and well-informed preference data from respondents. This approach can be used to derive a value set for preference-based instrument.

Penerapan Nesting terhadap Kualitas Tidur Bayi Berat Lahir Rendah (BBLR) di RSUD Ir. Soekarno Sukoharjo

Babies born with LBW conditions are more susceptible to disease and have a smaller chance of survival. Low birth weight (LBW) babies can cause developmental disorders both cognitively and motorically. Sleep is an important stage in repairing the neurological system in newborn babies. Poor quality sleep can cause illness and also cause psychological problems in LBW babies. Various developmental care efforts are made to minimize the negative impacts that arise during the treatment period, namely by optimizing the sleep quality of LBW babies, one way is by implementing nesting. Find out the results of the implementation of Nesting on the Sleep Quality of Low Birth Weight (LBW) Babies at the Ir. Soekarno Sukoharjo Regional Hospital. This type of research is a case study that uses descriptive pretest posttest design research methods and uses measurements of baby sleep quality. The results of the application to 2 respondents which were carried out for 2 days showed that there was an effect of nesting on improving the sleep quality of LBW babies. There were differences in the results before and after the nesting intervention on the sleep quality of LBW babies.